NPIMap

Individual provider Active NPI

Jeremy Diego Martinez, MD

  • Health Maintenance Organization
  • Elk Grove, CA
National Provider Identifier
1649362534
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
A78740 Issued in CA
Practice address
9521 Newington Way
Elk Grove, CA 95758-4443
Phone
(916) 432-0109
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X A78740 CA Primary

Addresses

Primary practice location

9521 Newington Way
Elk Grove, CA 95758-4443

Mailing address

9521 Newington Way
Elk Grove, CA 95758-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110503000283 CA Practitioner - Emergency Medicine 0648455873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
JS Weill Medical College, Cornell University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

173 E Webster St
Colusa, CA 95932-2949
Phone (209) 287-6308

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn Medical Center, LLC CurrentSince Jul 24, 2018 Accepting new patients
Glenn Medical Center, LLC Current Accepting new patients
American Specialty Physicians Group Inc CurrentSince Mar 24, 2018 Accepting new patients
Glenn Medical Center, LLC CurrentSince Jul 24, 2018 Accepting new patients
Central California Radiology Associates Inc Past Accepting new patients
Glenn Medical Center, LLC Past Accepting new patients
Sierra Rural Physicians, Inc. Past Accepting new patients

Locations

1191 Phelps Ave
Coalinga, CA 93210
Phone (559) 897-5841

151 E Webster St
Ste B
Colusa, CA 95932
Phone (209) 287-6308

240 Spruce St
Gridley, CA 95948
Phone (530) 846-5671

1250 E Almond Ave
Madera, CA 93637
Phone (559) 675-5501

700 17th St
Ste 205
Modesto, CA 95354
Phone (209) 248-7851

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

1133 W Sycamore St
Willows, CA 95988
Phone (530) 934-1800

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1649362534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9521 NEWINGTON WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9521 NEWINGTON WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584443",
            "telephone_number": "916-432-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JEREMY",
        "middle_name": "DIEGO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "A78740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.